Individual provider Active NPI

Chad Kovash, P.A.

  • Surgical Physician Assistant
  • Joliet, IL
National Provider Identifier
1275618639
Registry record updated May 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
363862771 Issued in IL
Practice address
1300 Copperfield Ave Ste 3070
Joliet, IL 60432-2065
Phone
(708) 349-0055
Fax
(708) 460-8031
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 363862771 IL Primary

Addresses

Primary practice location

1300 Copperfield Ave Ste 3070
Joliet, IL 60432-2065

Mailing address

10660 W 143Rd St Ste B
Orland Park, IL 60462-1989
Phone (708) 349-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000754 IL Practitioner - Physician Assistant 2961589684 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Regional Hospital & Healthcare Center Current Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Jun 5, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2021 Accepting new patients
Southwest Surgical Associates Past Accepting new patients
Midwest Emergency Northern Illinois Inc Past Accepting new patients

Locations

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBDBCD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210982400000",
    "number": "1275618639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST STE B",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621989",
            "telephone_number": "708-349-0055",
            "fax_number": "708-460-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 COPPERFIELD AVE STE 3070",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322065",
            "telephone_number": "708-349-0055",
            "fax_number": "708-460-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVASH",
        "first_name": "CHAD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "363862771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.